tbuckley/cabot-search huggingface dataset:
Duration and Death in Systemic Lupus Erythematosus
Authors: Edmund L. Dubois
Journal: JAMA (1974)

Of 491 patients with systemic lupus erythematosus (SLE), 249 (51%) are known dead. From 1950 to 1955, 15 of 57 patients (26%) died of central nervous system (CNS) damage and an equal number died of uremia. High-dosage corticosteroid therapy for CNS involvement was introduced in 1956. From 1956 to 1962, only 11 of 100 patients died of CNS involvement and 36% of the patients died of uremia. During the past ten years, with high-dose corticosteroid therapy, dialysis, and renal transplantation, only 7 of 92 patients (8%) died of CNS damage and 14% of the patients died of uremia. Death from infections, vascular complications, and malignant neoplasms occurred more frequently. The changes were significant (<i>P</i>&lt;.0001). Black patients did not have a more malignant course than others. The median time from diagnosis to death in 79 blacks was 3.5 years; this was identical in 170 other patients.
Primary Melanoma Cells of the Vertical Growth Phase: Similarities to Metastatic Cells&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Herlyn, Meenhard, Balaban, Gloria, Bennicelli, Jeannette, Guerry, DuPont, Halaban, Ruth, Herlyn, Dorothee, Elder, David E., Maul, Gerd G., Steplewski, Zenon, Nowell, Peter C., Clark, Wallace H., Koprowski, Hilary
Journal: JNCI Journal of the National Cancer Institute (1985)

Journal Article Primary Melanoma Cells of the Vertical Growth Phase: Similarities to Metastatic Cells Get access Meenhard Herlyn, Meenhard Herlyn Search for other works by this author on: Oxford Academic PubMed Google Scholar Gloria Balaban, Gloria Balaban Search for other works by this author on: Oxford Academic PubMed Google Scholar Jeannette Bennicelli, Jeannette Bennicelli Search for other works by this author on: Oxford Academic PubMed Google Scholar DuPont Guerry, IV, DuPont Guerry, IV Search for other works by this author on: Oxford Academic PubMed Google Scholar Ruth Halaban, Ruth Halaban Search for other works by this author on: Oxford Academic PubMed Google Scholar Dorothee Herlyn, Dorothee Herlyn Search for other works by this author on: Oxford Academic PubMed Google Scholar David E. Elder, David E. Elder Search for other works by this author on: Oxford Academic PubMed Google Scholar Gerd G. Maul, Gerd G. Maul Search for other works by this author on: Oxford Academic PubMed Google Scholar Zenon Steplewski, Zenon Steplewski Search for other works by this author on: Oxford Academic PubMed Google Scholar Peter C. Nowell, Peter C. Nowell Search for other works by this author on: Oxford Academic PubMed Google Scholar ... Show more Wallace H. Clark, Wallace H. Clark Search for other works by this author on: Oxford Academic PubMed Google Scholar Hilary Koprowski Hilary Koprowski Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 74, Issue 2, February 1985, Pages 283–289, https://doi.org/10.1093/jnci/74.2.283 Published: 01 February 1985 Article history Received: 23 February 1984 Accepted: 23 August 1984 Published: 01 February 1985
The Accuracy of Experienced Physicians' Probability Estimates for Patients With Sore Throats
Authors: Roy M. Poses
Journal: JAMA (1985)

Ten physicians recorded their treatment decisions and estimated probabilities of streptococcal infection for patients with sore throats. Of 308 throat cultures, 15 (4.9%) were positive for group A streptococci. The physicians overestimated the probability of a positive culture for 81% of their patients and their estimates and treatment decisions were strongly associated. Of 104 patients treated before culture results were available, only eight had positive cultures. Probability overestimation may have been due to (1) neglect of the low culture-positive rate, (2) assignment of undue importance to weakly predictive or highly intercorrelated clinical features, and (3) a value-induced bias, occurring when features important for treatment are erroneously linked to the likelihood of disease. Cognitive limitations in information processing may limit the effectiveness of pharyngitis management protocols that require subjective estimates of disease probability. (<i>JAMA</i>1985;254:925-929)
Recombinant Human Interleukin 1 Receptor Antagonist in the Treatment of Patients With Sepsis Syndrome
Authors: Charles J. Fisher
Journal: JAMA (1994)

<h3>Objective.</h3> —To further define the safety and efficacy of recombinant human interleukin 1 receptor antagonist (rhIL-1ra) in the treatment of sepsis syndrome. <h3>Study Design.</h3> —Randomized, double-blind, placebo-controlled, multicenter, multinational clinical trial. <h3>Population.</h3> —A total of 893 patients with sepsis syndrome received an intravenous loading dose of rhIL-1ra, 100 mg, or placebo followed by a continuous 72-hour intravenous infusion of rhIL-1ra (1.0 or 2.0 mg/kg per hour) or placebo. <h3>Outcome Measure.</h3> —Twenty-eight—day all-cause mortality. <h3>Results.</h3> —There was not a significant increase in survival time for rhIL-1ra treatment compared with placebo among all patients who received the study medication (n=893; generalized Wilcoxon statistic,<i>P</i>=.22) or among patients with shock at study entry (n=713; generalized Wilcoxon statistic,<i>P</i>=.23), the two primary efficacy analyses specified a priori for this trial. Results from secondary analyses suggest an increase in survival time with rhIL-1ra treatment among patients with dysfunction of one or more organs (n=563; linear dose-response,<i>P</i>=.009). Retrospective analysis demonstrated an increase in survival time with rhIL-1ra treatment among patients with a predicted risk of mortality of 24% or greater (n=580; linear dose-response,<i>P</i>=.005) as well as among patients with both dysfunction of one or more organs and a predicted risk of mortality of 24% or greater (n=411; linear dose-response,<i>P</i>=.002). <h3>Conclusions.</h3> —There was not a statistically significant increase in survivial time for rhIL-1ra treatment compared with placebo among all patients who received the study medication or among patients with shock at study entry. Secondary and retrospective analyses of efficacy suggest that treatment with rhIL-1ra results in a dose-related increase in survival time among patients with sepsis who have organ dysfunction and/or a predicted risk of mortality of 24% or greater. (<i>JAMA</i>. 1994;271:1836-1843)
Biological Warfare
Authors: LTC George W. Christopher
Journal: JAMA (1997)

The deliberate use of microorganisms and toxins as weapons has been attempted throughout history. Biological warfare has evolved from the crude use of cadavers to contaminate water supplies to the development of specialized munitions for battlefield and covert use. The modern development of biological agents as weapons has paralleled advances in basic and applied microbiology. These include the identification of virulent pathogens suitable for aerosol delivery and industrial-scale fermentation processes to produce large quantities of pathogens and toxins. The history of biological warfare is difficult to assess because of a number of confounding factors. These include difficulties in verification of alleged or attempted biological attacks, the use of allegations of biological attacks for propaganda purposes, the paucity of pertinent microbiological or epidemiologic data, and the incidence of naturally occurring endemic or epidemic diseases during hostilities. Biological warfare has been renounced by 140 nations, primarily for strategic and other pragmatic reasons. International diplomatic efforts, including the 1972 Biological Weapons Convention, have not been entirely effective in preventing the enhancement and proliferation of offensive biological warfare programs. The threats posed by biological weapons are likely to continue into the future.
Strangers at the Benchside: Research Ethics Consultation
Authors: Mildred K. Cho, Sara L. Tobin, Henry T. Greely, Jennifer McCormick, Angie Boyce, David Magnus
Journal: The American Journal of Bioethics (2008)

Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should be mitigated. We make preliminary recommendations for the structure and process of research ethics consultation, based on our initial experiences in a pilot program.
A case of generalized pustular psoriasis followed by bullous disease: and atypical case of bullous pemphigoid or a novel bullous disease?
Authors: H. SAEKI, N. HAYASHI, M. KOMINE, Y. SOMA, S. SHIMADA, K. WATANABE, T. HASHIMOTO
Journal: British Journal of Dermatology (1996)

We describe a 31‐year‐old Japanese woman with generalized pustular psoriasis treated with PUVA who subsequently developed a bullous disease. Throughout the disease coures, there was no phase of psoriasis vulgaris. Although several reports describe coexistence of psoriasis vulgaris and bullous disease such as bullous periphigoid, coexistence of generalized pustular psoriasis without any phase of psoriasis vulgaris and bullous disease is rare. As for the bullous disease, direct immunofluorescence study showed lgG and C3 deposition along the basement membrane zone. Indirect immunofluorescence disclosed lgG antibasement membrane zone antibodies. Indirect immunofluorescence on 1 mol/1 sodium chloride‐split skin demonstrated linear lgG staining almost exclusively on the dermal side of the split. Western immunoblot analysis revealed that the antibody was directed to neither epidermolysis bullosa acquisita antigen nor bullous pemphigoid antigens. Considering the unusual clinical course, we suspect the possibility of a novel autoimmune blistering disease.
Non-pigmented modular plantar melanoma in 12 Japanese patients
Authors: T. KATO, N. TABATA, T. SUETAKE, H. TAGAMI
Journal: British Journal of Dermatology (1997)

In the Japanese, melanoma most commonly involves the plantar surface. Among 61 patients with plantar melanoma, we diagnosed 50 patients as acral lentiginous melanoma (ALM), nine as nodular melanoma, and two as superficial spreading melanoma. Partial or complete loss of pigment was observed in four of the nine nodular melanoma cases and in the nodular portions of eight ALM cases. All 12 such nodular lesions were ulcerated. The clinical diagnosis of malignant melanoma was easily made in the eight patients with ALM by the characteristic pigmentary changes around the nodule. The presence of some remaining pigment was found to be helpful in making the diagnosis in two lesions of nodular melanoma which, at first, had been clinically diagnosed as eccrine poromas. One of two completely amelanotic nodular melanomas was strongly suspected to be a melanoma because there was a history of a pre–existing pigmented macule before the development of the nodule. The other one required histopathological differentiation from Merkel cell carcinoma. Based on these findings and compared with melanoma on other parts of the body, pigmentation noted in the ulcerative nodule of plantar melanoma seems to disappear easily. This causes difficulty in distinguishing it from other skin tumours.
Pmphigus in Mali: a study of 30 cases
Authors: A. MAHÉ, B. FLAGEUL, I. CISSÉ, S. KÉITA, P. BOBIN
Journal: British Journal of Dermatology (1996)

Journal Article Pmphigus in Mali: a study of 30 cases Get access A. MAHÉ, A. MAHÉ Institut Marchoux, BP 251, Bamako, Republic of Mali Dr A. Mahé, Service de dermatologe. CHU de Pointeà‐Pitre, 97159 Pointe‐à‐Pitre Cedex, Guadeloupe, French West Indies. Search for other works by this author on: Oxford Academic Google Scholar B. FLAGEUL, B. FLAGEUL Service de dermatologie (Pr Dubertret). Hôpital Saint‐Louis, I avenue Claude Vellefaux, 75010, Paris, France Search for other works by this author on: Oxford Academic Google Scholar I. CISSÉ, I. CISSÉ Institut Marchoux, BP 251, Bamako, Republic of Mali Search for other works by this author on: Oxford Academic Google Scholar S. KÉITA, S. KÉITA Institut Marchoux, BP 251, Bamako, Republic of Mali Search for other works by this author on: Oxford Academic Google Scholar P. BOBIN P. BOBIN Institut Marchoux, BP 251, Bamako, Republic of Mali Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 134, Issue 1, 1 January 1996, Pages 114–119, https://doi.org/10.1046/j.1365-2133.1996.d01-745.x Published: 01 January 1996 Article history Accepted: 17 March 1995 Published: 01 January 1996
Angiotensin-converting enzyme (ACE) inhibitors and angio-oedema
Authors: R.A. SABROE, A.KOBZA BLACK
Journal: British Journal of Dermatology (1997)

Angiotensin–converting enzyme inhibitors (ACEIs) are used increasingly for the treatment of hypertension and chronic heart failure, and they reduce mortality when given after myocardial infarction. Of the patients prescribed these drugs 0.1–0.7% develop angio–oedema, but the association is not widely recognized. In 60% of cases the onset occurs during the first week of treatment; however, it may be considerably delayed. Angio–oedema nearly always occurs on the head and neck, frequently involving the mouth, tongue, pharynx and larynx. The course is unpredictable, and attacks vary in severity from mild to fatal from laryngeal obstruction. Severe ACEI–induced angio–oedema may require emergency treatment with adrenalin and early intubation. The drug should be withdrawn in any patient who presents with ACEI–induced angio–oedema, and treatment continued with an appropriate drug of a different class. Therapy with ACEIs is contraindicated in patients with a prior history of idiopathic angio–oedema, or in patients with hereditary or acquired Cl esterase inhibitor deficiency.
Treatment of psoriasis with intermittent short course cyclosporin (Neoral<sup>®</sup> ). A multicentre study
Authors: J. BERTH-JONES, C.A. HENDERSON, C.S. MUNRO, S. ROGERS, R.J.G. CHALMERS, M.J. BOFFA, P.G. NORRIS, P.S. FRIEDMANN, R.A.C GRAHAM-BROWN, P.M. DOWD, R. MARKS, M.J. SUMNER
Journal: British Journal of Dermatology (1997)

A 1 year, prospective multicentre study was performed to investigate the efficacy and safety of intermittent treatment with cyclosporin in psoriasis vulgaris. Subjects received cyclosporin (Neoral(r)) 5mg/kg per day until achieving 90% reduction in area affected, or for a maximum of 12 weeks. Those failing to demonstrate a satisfactory response were withdrawn. When further treatment was required, cyclosporin was recommenced. This cycle was repeated up to three times. Psoriasis activity was recorded using the area affected and sign scores for erythema, scaling and infiltration. Overall assessments of response and tolerability were recorded. Forty-one subjects, mean age 36, mean PASI 12·8, entered the first treatment period. Thirty-three received a second period of treatment and 16 a third. Eighteen failed to complete the study as planned: five were withdrawn due to adverse events, four due to treatment failure and nine due to protocol violations. At the end of each treatment period, significant improvements were seen in all efficacy parameters. Overall response was graded as ‘considerable improvement’ or ‘minimal or no symptoms’, by over 80% of subjects and investigators. Median intervals to relapse for subjects remaining in the study were 72 days (range 28–329) and 53 days (range 14–141) after periods 1 and 2, respectively. There were significant increases in mean serum creatinine and blood pressure during each treatment period. However, there were no significant differences in either parameter between baseline and the final follow-up visit. At the end of each treatment period, overall tolerability of the treatment was considered ‘good’ or ‘very good’ by over 80% of subjects and investigators.
Suppression of tumour necrosis factor-α expression in leprosy skin lesions during treatment for leprosy
Authors: Y. SUGITA, M. MIYAMOTO, M. KOSEKI, N. ISHII, H. NAKAJIMA
Journal: British Journal of Dermatology (1997)

The expression of tumour necrosis factor (TNF)‐α in leprosy skin lesions was examined before and during successful treatment in a patient with borderline lepromatous leprosy. Before treatment, immunohistochemical staining of a skin biopsy specimen showed diffuse TNF‐α deposits in granulomas and significant TNF‐α deposits on infiltrated mononuclear cells. After 1 year's treatment, the skin lesions exhibited a reduction in granulomas, and a concomitant reduction in deposits of TNF‐α. Furthermore, the level of expression of TNF‐α messenger RNA. as examined using a reverse transcriptase‐polymerase chain reaction method, was reduced markedly after treatment. These findings provide evidence for a correlation between the expression of TNF‐α and disease activity suggesting that TNF‐α is a useful prognostic indicator for inflammation in leprosy.
Epidermal cell DNA content and intermediate filaments keratin 10 and vimentin after treatment of psoriasis with calcipotriol cream once daily, twice daily and in combination with clobetasone 17-butyrate cream or betamethasone 17-valerate cream: a comparat
Authors: C.P. GLADE, P.E.J. VAN ERP, P.C.M. VAN DE KERKHOF
Journal: British Journal of Dermatology (1996)

Calcipotriol and corticosteroids, two therapy modalities frequently prescribed in the treatment of psoriasis, are often used in combination. The aim of the present study was to determine whether the cell biological response pattern of concurrent use of calcipotriol and corticosteroids is different from calcipotriol monotherapy. Forty patients with chronic plaque psoriasis were divided at random in four parallel groups and treated for 8 weeks with: (1) calcipotriol cream (50 μg/g once daily); (2) calcipotriol cream twice daily; (3) calcipotriol and clobetasone 17-butyrate (0.5 μg/g) creams; and (4) calcipotriol and betamethasone 17-valerate (1 mg/g) creams. Before and after treatment keratotome biopsies were taken and single cell suspensions prepared for flow cytometric analysis. Flow cytometric multiparameter quantification of markers for proliferation (TO-PRO-3), differentiation (antikeratin 10) and inflammation (antivimentin) was used to evaluate all four therapy modalities. A statistically significant decrease of the percentage of basal cells in S- and G2M-phase (proliferation)was obtained with all therapy modalities, except for calcipotriol monotherapy applied once daily. A significant reduction of the number of vimentin-positive cells (non-keratinocytes) was observed following combined treatment with calcipotriol and clobetasone butyrate. In contrast, monotherapy with calcipotriol had virtually no effect on the number of vimentin-positive cells. It can be concluded that: (i) calcipotriol monotherapy, applied once daily was less antiproliferative compared with twice daily applications of calcipotriol or the combined treatment with corticosteroids and that (ii) the combination of calcipotriol and corticosteroids proved to have a marked effect on the percentage of non-keratinocytes, in contrast to the modest effect of calcipotriol.
Evaluation of 6 weeks treatment of terbinafine in tinea unguium in a double-blind trial comparing 6 and 12 weeks therapy
Authors: I. TAUSCH, M. BRÄUTIGAM, G. WEIDINGER, T.C. JONES
Journal: British Journal of Dermatology (1997)

Terbinafine (Lamisil) has been registered throughout the world for the treatment of finger and toenail onychomycosis. The recommended duration of treatment of toenail onychomycosis based on phase III studies is 12 weeks. This study was designed to determine: (i) if patients in whom the proximal part of the toenails was not affected respond as well after 6 weeks treatment as after 12 weeks treatment; (ii) to identify factors which may allow selection of patients for shorter treatment duration; and (iii) confirm that 6 weeks therapy is sufficient in fingernail mycosis. One hundred and forty-eight patients received 250 mg terbinafine daily for either 6 or 12 weeks in a double- blinded manner, and were followed until 48 weeks after start of therapy. Cure of the nail infection was defined as negative mycological tests (mycological cure) and progressive growth of normal nail (clinical cure). Mycological cure was recorded in 43 of 72 (59.7%) in the 6-week group and 55 of 76 (72.4%) in the 12-week group. In those who completed the study per protocol in the 6-week group. 34 of 61 (55.7%) were cured mycologically corresponding to 46 of 56 (82.1%) in the 12-week group. The overall clinical and mycological cure rates for the two groups were 28 of 61 (45.9%) and 33 of 56 (58.9%), respectively. In the small number of patients with associated fingernail infection, all were improved and six of eight (75.0%) were cured after a duration of treatment of 6 weeks. A priori risk factors for failure of cure could not be identified in either group. However, shorter duration of disease prior to treatment and no involvement of the big toenail was associated with a trend toward better responses in both groups. It can be concluded from this study that, in toenail mycosis without visible matrix involvement, 6 weeks treatment of terbinafine is generally not sufficient, whereas fingernail infections respond well to this short therapy.
In situ analysis of transforming growth factors-β(TGF-β1, TGG-β2, TGF-β3) and TGF-β type II receptor expression in basal cell carcinomas
Authors: P. SCHMID, P. ITIN, TH. RUFLI
Journal: British Journal of Dermatology (1996)

Transforming growth factor-beta (TGF-β) consists of a highly homologous family of multifunctional peptides which are differentially expressed and function in a wide range of target cells. Aberrant expressions of TGFβs have been implicated in a number of disease processes, particularly those involving fibrotic and inflammatory lesions, and loss of TGF-β growth inhibition may play a part in the progression of certain neoplasms. In the present study, we have analysed and compared, by in situ hybridization, mRNA expression of transforming growth factors-β(TGF-β1, TGF-β2. TGF-β3) and TGF-β type II receptor (TβR II). and. by immunohistochemistry, the distribution of TGF-β3 protein in normal human skin and in basal cell carcinoma (BCC). The stroma of most BCCs revealed enhanced TGF-β1 and TβR II mRNA expression when compared with normal dermis. A minority of BCCs also showed stromal overexpression of TGF-β2 and/or TGF-β3 mRNA. However, tumour tissues of all BCCs revealed weaker TGF-β3 mRNA and protein expression than normal interfollicular epidermis and hair follicle epithelia, whereas expression of TGF-β1 mRNA was comparably weak in tumour tissues and normal skin epithelia. Expression of TGF-β2 mRNA, which was clearly detectable in distinct hair follicle epithelia, was only barely detectable in normal interfollicular epidermis and in tumour tissues. In contrast, abundant TβR II mRNA expression was observed both in normal skin epithelia and tumour tissues. From these findings, we suggest that increased stromal TGF-β activity induces fibrotic alterations which promote tumour survival and/or progression via paracrine mechanisms, whereas lack of TGF-β expression by tumour cells may contribute to an autocrine growth control defect in BCCs.
Childhood paraneoplastic pemphigus associated withCastleman's tumour
Authors: M.A. LEMON, W.L. WESTON, J.C. HUFF
Journal: British Journal of Dermatology (1997)

Paraneoplastic pemphigus (PNP) is a rare condition virtually always seen in adults. We report a 13 year-old boy who developed PNP associated with Castleman's tumour. His condition mimicked Stevens-Johnson syndrome and responded to tumour resection and immunosuppressive therapy.